Thursday, 10 August 2017

Autism and Responsibility

On June 7th, Ken Richman (MCPHS University,
Boston) and Julian Savulescu (Oxford) hosted a small workshop on autism and
moral responsibility at the University of Oxford.

Some philosophers have argued
that impaired cognitive empathy prevents autistic individuals from being fully morally
responsible. Neuropsychologists working on autism, philosophers working on
moral responsibility and psychiatric illness, autistic adults, and students and
postdocs at the Oxford Uehiro Center for Practical Ethics came together to discuss autism
and responsibility. Throughout the discussion, we focused on autistic
individuals with average or higher intelligence, rather than those who also experience
intellectual disability.

One of the first issues addressed was that questioning the moral
responsibility of a certain group is extremely sensitive, as exempting
individuals from responsibility entails doubting their moral agency, either in
a specific situation or more generally. Such considerations might even be used
to exclude a person from school or the workplace.

The capacities relevant to moral responsibility are generally
considered to be volitional capacity (control) and understanding of the
consequences and moral character of one’s actions. Both are affected by autism
to some extent. However, autistic individuals are not more prone to committing
crimes than the general population, and are not unusually prone to other kinds
of immoral behaviour, either. My impression from the discussion was that
problems arise most frequently when people are in overwhelming situations, or there can also be problems with inappropriate social behaviour, such as unintended rudeness.

It was pointed out that for most mental disorders, the disorder
does not provide a blanket excuse or exemption from responsibility. Rather,
what needs to be considered is how specific features of the disorder affected a
specific action in order to make a case by case decision regarding excuse. For
example, when making a responsibility judgment regarding an autistic child’s
meltdown in a noisy situation, we need to take into account how much more
stressful certain situations are for autistic children, as well as possible
problems with volitional control. This implies that a global assessment of
moral incapacity is inappropriate.

Under the label ‘authenticity’ we discussed approaches to
moral responsibility and agency that require a morally competent agent not only
to do the right thing, but to do it with the right feelings and attitudes. Examples
introduced were comforting behaviour without typical feelings of empathy, and
apologies without emotional appreciation of the harm done. In reaction to this,
some of the participants with more experience with or of autism doubted that
such descriptions, which ascribe a lack of affect to autistic individuals, are
in fact accurate. It was pointed out that individuals with autism experience
affective empathy and emotional contagion and primarily struggle with cognitive
empathy, understanding and predicting what other people think.

Issues are
further complicated by another feature common among autistic people:
alexithymia, the inability to identify and describe one’s own emotions. So it
is important to note is that while the affective responses to other people’s
plights may well be different, this does not mean that emotional responses are
absent. Furthermore, many of us believed, contra
some Strawsonian approaches, that the emotions with which individuals do the
morally right thing should not feed into our moral evaluation of their actions,
even if they may well influence other aspects of interpersonal relationships.

The last point we discussed was whether autism has any
effect on autonomy and people’s ability to make decisions for themselves. One
frequently observed phenomenon is that parents of autistic children are often
slower to let them make their own decisions because they want to protect them
from ill-considered decisions arising from an inability to appreciate relevant
options for action, or insufficient appreciation of the way their condition may
affect the success of an action or project. In other words, there can be a
struggle to balance respect with paternalistic care for autistic individuals’
welfare.

The workshop generated a very rich and interesting
discussion which benefited immensely from the different perspectives that
informed the conversation.